Transient Oxygen Desaturation Associated with Persistent Right Venous Valve-Mediated Right-to-Left Atrial Shunt in Term Neonates

Background: Persistent right venous valve (PRVV), a remnant of the fetal right valve of the sinus venosus, may facilitate right-to-left atrial shunting through the patent foramen ovale (PFO). Although PRVV has been reported to cause severe neonatal cyanosis requiring surgical intervention, its clinical significance in otherwise healthy term neonates remains poorly defined. Methods: values during hospitalization were assessed. Results: values remained high (95-100%) in all cases. These desaturation episodes occurred predominantly during sleep and were frequently synchronized with inspiration, suggesting a circulatory rather than respiratory mechanism. Although some neonates experienced transient desaturation reaching as low as 80%, none developed sustained hypoxemia, required prolonged oxygen supplementation, or underwent additional respiratory investigations or therapeutic interventions. All neonates remained clinically stable throughout hospitalization. Conclusion: decreases and avoid unnecessary respiratory evaluations in selected neonates.